By Chioma Obinna

The Federal Government’s push for universal health insurance gained fresh momentum yesterday as the National Health Insurance Authority, NHIA, and the Healthcare Federation of Nigeria, HFN set a 2026 target to unlock enrolment for millions of Nigerians in the informal sector, in what stakeholders described as “a race against an overwhelming population curve.”

At a high-level private-sector roundtable in Lagos, participants agreed that mandatory health insurance will collapse without firm enforcement, technology integration and restored public trust.

The private sector leaders also warned that without a national digital backbone, mandatory insurance may fail to reach the informal sector.

The warning comes as Nigeria’s population now estimated at 220 million grows by more than six million people every year, raising the urgency for rapid scale-up.

The NHIA Director-General, Dr Kelechi Ohiri, said Nigeria is entering a decisive phase, stressing that the Authority must shift from legislative intent to practical protection for households.

“Mandatory health insurance will not succeed on legislation alone. Enforcement, awareness and, most importantly, restoring trust are essential,” Ohiri said.

“Government cannot do this alone. To reach the informal sector at scale, we must unlock the innovation and operational agility the private sector brings.”

Speaking, the HFN President, Mrs Njide Ndili, said the roundtable marked the first in a structured engagement series to align public–private priorities in health financing. She noted that the partnership signalled a shared responsibility for strengthening the system.

“Our collaborations in quality improvement, manufacturing, emergency care and data systems are designed to strengthen both demand and supply sides of healthcare,” she said.

Ndili reaffirmed HFN’s commitment to coordinating private-sector actors and supporting NHIA reforms to ensure that Nigeria’s march toward universal health coverage is inclusive, sustainable, and innovation-driven.

In his presentation, Dr Leke Oshunniyi, former chairman of the Health & Managed Care Association of Nigeria, HMCAN, warned that without an integrated national digital architecture, Nigeria’s health insurance expansion would be impossible.

“Any law without enforcement is just good advice. The real elephant we must eat in little bits is technology. We need a platform that aggregates data from telcos, NIMC, FRSC, tax authorities and providers. Without that digital backbone, every other effort is floating in the air.”

He added that fintechs already serve millions of Nigerians, demonstrating that mass-market digital systems are feasible.

Oshunniyi urged the NHIA to partner with global cloud providers and local tech innovators to build scalable infrastructure capable of accommodating 300 million Nigerians over the next decade.

Throughout the sessions, speakers outlined urgent actions needed to accelerate nationwide enrolment.
Reflecting on the broader national challenge, Oshunniyi cautioned that Nigeria must enrol at least six million new people every year just to keep up with population growth.

“From small acorns, mighty oaks grow. But we must act now. The private sector is ready. What we need is clarity, enforcement and the right technology.”

They stressed the need for strict enforcement of the NHIA Act and a fully interoperable national data system that links existing government and private-sector databases.

The different speakers who took turn to speak also highlighted the importance of developing micro-insurance products tailored to informal workers, integrating telemedicine to improve rural access, expanding market-driven enrolment channels, upgrading primary healthcare quality, and deploying fintech-driven payment and financing models to ease affordability.

Another strong theme was the need to rebuild trust in the insurance system through transparent claims processes, improved quality of care and strong quality-assurance mechanisms driven by both public and private actors.

The participants agreed to establish an NHIA–HFN joint working group on technology and data integration, to map private-sector innovations ready for scale, and to support the planned Informal Sector Coverage Fund.

A follow-up implementation session with the NHIA Director-General is scheduled for January 2026.
In a related presentation, Prof Bode Falase of LASUTH shared new data from the Nigeria Open-Heart Surgery Registry, the only online registry of its kind in sub-Saharan Africa.

He said the registry has recorded 1,916 surgeries across 28 centres between 2004 and 2025, with 58 percent of procedures now carried out by local teams.He said the annual activity is expected to reach 300 cases this year—its highest since inception reflecting rapid growth despite persistent systemic constraints.

Falase warned that sustainability remains uncertain due to reliance on a small grant and voluntary reporting. “We urgently need funding to sustain the registry. Voluntary reporting is improving, but data validation and long-term support remain weak,” he said.

He noted that the rising cost of advanced procedures, such as mechanical mitral valve replacement priced at about ₦8.5 million in LASUTH, underscores why Nigeria’s health insurance system must evolve to support high-cost care, as is standard in other regions of the world.